Dolor de espalda

Back pain is a symptom of a medical condition, not a diagnosis itself. To determine the cause and nature of your pain, your doctor may:

• Ask you about your medical history, including the nature of your pain and any health problems you or your family have.
• Give you a physical exam.
• Take x-rays to look at your bones.
• Use magnetic resonance imaging (MRI) get pictures of your soft tissues, such as ligaments, tendons, and blood vessels.
• Use a computed tomography (CT) scan to see a three-dimensional image of your back.
• Take blood in some cases.

Treatment for back pain generally depends on how long your pain lasts:

• Acute (short-term) back pain usually gets better on its own. Exercises or surgery are usually not recommended for this type of pain. There are some things you may try while you wait for your pain to get better:
  • Acetaminophen, aspirin, or ibuprofen will help ease the pain.
  • Get up and move around to ease stiffness, relieve pain, and have you back doing your regular activities sooner.
• Chronic (long-term) back pain is typically treated with nonsurgical options before surgery is recommended.
  • Nonsurgical Treatments:
    • Hot or cold packs can be soothing to constantly sore, stiff backs.
    • Exercise can help ease chronic pain and may reduce the risk of it returning. Check with your doctor before starting a new exercise routine.
    • Medications¹ to treat chronic back pain are available over the counter or by prescription.
      • Pain relievers that are taken by mouth or applied to the skin. Examples include acetaminophen and aspirin.
      • Nonsteroidal anti-inflammatory drugs (NSAIDs)¹ relieve pain and inflammation. Examples include ibuprofen, ketoprofen, and naproxen sodium.
      • Muscle relaxants and some antidepressants may be prescribed for some types of chronic back pain.
      • Your doctor may suggest steroid or numbing shots to lessen your pain.
    • Traction involves using pulleys and weights to stretch the back, which may allow a bulging disk to slip back into place. Your pain may be relieved while in traction, although pain returns once you aren’t in traction.
    • Behavioral modification teaches you to:
      • Move your body properly while you do daily activities, especially those involving heavy lifting, pushing, or pulling.
      • Practice healthy habits, such as exercise, relaxation, regular sleep, proper diet, and quitting smoking.
    • Complementary and alternative treatments are an option when medications and other therapies do not relieve pain. Examples include:
      • Manipulation. Professionals use their hands to adjust or massage the spine or nearby tissues.
      • Transcutaneous electrical nerve stimulation (TENS). A small box over the painful area sends mild electrical pulses to nerves. TENS treatments are not always effective for reducing pain.
      • Acupuncture. This Chinese practice uses thin needles to relieve pain and restore health. Acupuncture may be effective when used as a part of a comprehensive treatment plan for low back pain.
      • Acupressure. A therapist applies pressure to certain places in the body to relieve pain. Acupressure has not been well studied for back pain.
  • Surgical treatments may be necessary in some cases, including:
    • Herniated (ruptured) disks, where one or more of the disks that cushion the bones of the spine are damaged. The jelly-like center of the disk leaks, causing pain.
    • Spinal stenosis, a narrowing of the spinal column that puts pressure on the spinal cord and nerves.
    • Spondylolisthesis, where one or more bones in the spine slip out of place.
    • Vertebral fractures caused by injury to the bones in the spine or by osteoporosis.
    • Degenerative disk disease, or damage to the spine’s disks as a person gets older.

In rare cases, back pain is caused by a tumor, an infection, or a nerve root problem called cauda equina syndrome. In these cases, surgery is needed right away to ease the pain and prevent more problems.

Footnote

^1. All medicines can have side effects. Some side effects may be more severe than others. You should review the package insert that comes with your medicine and ask your health care provider or pharmacist if you have any questions about the possible side effects. Go to reference

^2. Warning: Side effects of NSAIDs include stomach problems; skin rashes; high blood pressure; fluid retention; and liver, kidney, and heart problems. The longer a person uses NSAIDs, the more likely he or she is to have side effects, ranging from mild to serious. Many other drugs cannot be taken when a person is being treated with NSAIDs, because NSAIDs alter the way the body uses or eliminates these other drugs. Check with your health care provider or pharmacist before you take NSAIDs. NSAIDs should only be used at the lowest dose possible for the shortest time needed. Go to reference

You probably don’t need to see your doctor for back pain, unless you have:

• Numbness and tingling.
• Severe back pain that does not improve with medication.
• Back pain after a fall or injury.
• Back pain along with:
  • Trouble urinating.
  • Weakness, pain, or numbness in your legs.
  • Fever.
  • Weight loss that you didn’t intend.

Many different types of doctors treat back pain:

• Family or primary care doctors (usually seen first).
• Doctors who specialize in disorders of the nerves, muscles, or skeleton.

Work with your doctor to develop a plan to help prevent many types of back pain. The plan should include:

• Regular exercise that keeps your back muscles strong. Exercises that increase balance and strength can decrease your risk of falling and injuring your back or breaking bones. Exercises such as tai chi and yoga—or any weight-bearing exercise that challenges your balance—are good ones to try.
• Eating a healthy diet that includes enough calcium and vitamin D, nutrients that keep your spine strong. A healthy diet also helps in controlling weight to avoid putting unnecessary and injury-causing stress and strain on your back.
• Practicing good posture, supporting your back properly, and avoiding heavy lifting when possible.